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For “How it all began” see here

I’ll be honest, I did not expect the “mental fitness” portion of kidney donation to be the trial that it was. Mental fitness apparently means fitting into someone’s definition of stable and sane, plus proving cognitive competence, plus proving you are not being compelled or compensated to donate.

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Wake me when the analysis is over, k?

1977 has never been so germane

I should have had an inkling when I first spoke to a psychologist, back in March during my hospital day. “Tell me about your family,” she said. So I began to talk about my husband and children, and she interrupted and said, no, when you were growing up.

Naturally, I had to explain that my parents were divorced, and that I had lived with my mom afterwards, because all this went down in the late 1970s and this is, by and large, what happened.

“I don’t understand why this is important,” I said.

We moved on to other topics, like an assessment of my taking risks and my impulsivity. I tried to downplay how impulsive my decision to “go” for this kidney donation was – because it does not match with most of my other decisions over the course of my life. It just felt…right, to be honest. Like being able to see that a puzzle piece will fit before you even try it.

Anyway, I had to wait to be summoned by the Department of Health for my mental health check. I waited for several weeks, all the while kind of in anguish about the ill young man who might (but might not) be getting my kidney when all this was through – and how this was a stupid gauntlet.

In mid-May, I finally had my chance to prove my mental fitness.

It was by far the hardest part of the entire process.

“Tell me about your parents’ divorce,” was practically the opening salvo, and “Well, it was 41 years ago, so I don’t think it’s had a huge impact on my adult life,” was not an acceptable answer.

It turns out that I am loathe to share my innermost feelings with a stranger who will be judging me. Who knew?

After an hour of questioning about every major life event (my parents’ “new” marriages – now clocking in at 37 years and 33 years, respectively, and my relationships with my parents and stepparents; moving across the country as a teenager; becoming religious; studying in Israel; getting married; moving to Israel), I was given a Rorschach test.

Nope, not kidding. Yes, an actual Rorschach test.

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What do you see?

They had told me at the hospital that this would be included, so I poked around online before. The inkblots they showed me were the exact ones from like 1921 or whatever.

The psychologist was suspicious that I knew what a Rorschach was. “How do you know what this is?” she asked. “I’m 43 years old?” I said, “And I’m fairly well versed in popular culture?” (NB: Not Star Wars or comic-based things or Hamilton. But Rorschach shows up all the time? Or did? In the last century, which I partially remember because I am 43?)

I was then tested in my ability to reproduce drawings of shapes and lines, first just copying and then from memory. I couldn’t imagine what this had to do with my mental state, but a friend who is an occupational therapist with lots of hospital experience told me it was judging if I’d be able to care for myself competently after the surgery. (Which they would never let me have, it was clear, unless I had a roster of people who could commit to caring for me. Irony alert?)

Then I had to draw some things (a house, a tree, a person) and make up stories about them. By this point I was entirely fried. Even under the best of circumstances I can’t draw well, and now everything seemed to be coming out of the pencil point incorrectly.

Finally, the test was done.

“When will I know the results?” I asked the psychologist.

“I’ll be finished with my report within a couple of days,” she said, “but then your file goes back to Beilinson and….”

Right. Got it.

I walked out shaky and feeling like my physical fitness really did not count for enough here, but it should.

Back on Earth

Meanwhile, I had started to tell people that I was planning to donate a kidney.

(I had told my parents in the beginning, as I needed some details about family health history. They were both underwhelmed and worried.)

Most people were shocked, but past that initial surprise, I got a wide range of responses. A few friends who are nurses were thrilled. Other people were confused as to why I’d do this. I got a few “oh, this totally seems like something you would do,” which seemed like a weird cover since I really hadn’t considered it before – I’ve been a long-time advocate of post-death organ donation, but live donation is…different.

My closest friends immediately wanted to plan a meal train, because food (and coffee) is how you show you care.

My boss took it in stride, mostly because she’s done crazier things in her life.

A Long Month

I did not hear back from the transplant staff for a month.

I sent occasional texts, asking for updates. Meanwhile, we had to plan our summer. My parents wanted to see us and the kids. (Mostly the kids?) We bought plane tickets, not knowing if I was going to have surgery before August. For the first time ever, we bought cancellation insurance. What if I couldn’t go?

Finally, finally, I received word that I was set up for the final hurdle – a tribunal.

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Hear ye, hear ye, nothing to fear except REJECTION

(The word in Hebrew is vaada, which I guess could be construed as “committee,” but tribunal really captures the feeling.)

The vaada was basically the opportunity for knowledgable professionals who had no ties to anyone or anything in the kidney donation process to make sure I was sane, competent, informed, and acting with free will.

It was 45 minutes of questioning before a doctor (a pediatrician), a lawyer, a psychologist, a nurse, and a social worker. I got to recite stats! Like my chance of dying on the table (1 in 3,000) and my chance of contracting kidney disease with one kidney (6% vs 2% if I kept 2 kidneys). I got to answer/laugh at ridiculous questions like “if God gave you two kidneys, who are you to give one of them away?” and “How can you ensure that the recipient will take care of the donated kidney?”

Compared to the one-on-one with the psychologist, it felt pretty easy. Although someone (the lawyer, maybe?) noted that I seemed tense and I needed to remember that everyone was on my side. Hahahahaha!

In a surprise twist, Taxman and I met the recipient and his partner. He was facing his own vaada – which was much shorter than mine. (I guess he had to prove that he would act in good faith and treat a new kidney nicely?) We learned more about his medical history, such as it was – his kidney failure had come on suddenly, after a seemingly insignificant illness (fever led to a doctor’s visit, where his bp was so high it resulted in an ER trip, where surprise! He was in renal failure and started dialysis the next day).

(This was suddenly feeling very Israeli, as a strict protocol was being broken. Altruistic kidney donors are not supposed to meet the recipients beforehand; as the nurses at Beilinson had told me, donors can drop out at any time – even on the day of the surgery. I was feeling very confident in my decision, but what if I weren’t?)

We were told to expect an answer within a couple of days.

But we were given the go-ahead within hours.

Coming up in part III, a plan comes together

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In a shocking turn of events (admittedly, not to me or a few others), I donated my left kidney last week.

How did this happen? Am I crazy? What was I thinking?

I will try to lay it out in a logical way, perhaps in a vain effort to make people see that what I did is not heroic, but rather just a stretch of “normal” (or what should be normal), and encourage people to check it out for themselves.

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If only kidneys were so readily available

In the beginning

During the last Shabbat of 2017, we were away visiting family. Instead of sitting next to my daughter in synagogue on Friday night, I was sitting behind her and my niece. She was reading an alon Shabbat, a free weekly newspaper, and I noticed an ad with a bright pink background and white lettering. Seeking kidney donation, blood type A, please contact [name/phone number].

This is my blood type. But I haven’t even donated blood in a long time, because the drives all seem to be in the evenings when my kids need to be schlepped to and from tennis lessons or birthday parties or the library, and yelled at to shower or eat dinner or unload the dishwasher, and I don’t have 90 minutes to drive across town, wait in line, donate, wait some more, and then come home.

Anyway, I couldn’t get this ad out of my mind. This is a country that prides itself on its inhabitants behaving like family. Even if your family is small, your friends and neighbors, coworkers and fellow students are supposed to bridge the gaps for you. But clearly whoever was on the other side of this ad was out of those options and was reaching out – to strangers. It was haunting.

As Taxman was falling asleep that night, I said, “What would you say if I wanted to donate my kidney?”

“I would support you,” he said.

Over Shabbat we talked it about it more, and that week he reached out via phone to the name behind the ad. “She was very emotional,” he reported about his conversation. “It’s for her partner. Nobody else has responded.” We collected a lengthy list of tests that the transplant center at Beilinson Hospital demanded as a preamble – and I began.

January to March

Imagine filling out forms in triplicate and that kind of sums up the preliminary testing.

  • Blood pressure at the nurses’ station – 3 times
  • Urinalysis + blood panel – 3 times

Plus a kidney ultrasound and, to my delight, a 24-hour urine collection for creatinine testing.

My results were shipped off via the internets to the transplant department at Beilinson Hospital (regarded as the top transplant facility in the country – and why this potential recipient already had a file open there).

Mid-March – An invitation to the mothership

Once these results had been digested by the Powers that Be in PT (Petach Tivka, location of Beilinson Hospital AKA Rabin Medical Center WHY DOES EVERYTHING IN ISRAEL HAVE FOUR NAMES?), I was invited to come in and have more screenings and get some more information.

I met with the nurse who takes care of the administrative side of kidney donation at the hospital. As we spoke, she took note of my blood pressure about seven times. You know, like you do.

A few other potential donors had also been summoned that morning, and we met in a group with a nephrologist, who was the first of probably a dozen people to describe the surgery, its risks (immediate and long-term), and the long-term pros and cons of a donation. Later that morning, she took my family history and did an initial physical exam.

I had Taxman with me, both as a translator and to minimize my having to relate the entire morning later. Obviously, it was important that he was on board – but we had no idea how important until later.

End of March – Images, images, and a glance into my psyche

Still in it to win it (something in the nephrologist’s stats had been enough to cause one potential donor to excuse himself in the middle of the round), I was called back to Beilinson in late March for a day of testing. More blood and urine – this should go without saying – and other tests:

  • EKG
  • Heart echo
  • Chest X-ray
  • CT scan with contrast (presumably focused on my kidneys)

I spoke to both a psychologist and a social worker, to try to answer the why I wanted to do this and how I would cope with having a major surgery fall into the midst of my otherwise uneventful life.

For the first time of many, I described myself as taking only small risks, as in whatever is required to function – the first time of many when I made a joke about the risks of driving on Israeli highways – but ultimately feeling a responsibility to share my good health with someone who hasn’t been gifted in the same way.

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Israeli highways and byways – not for the risk-averse

The last physical test – and a major test of my patience

I had to get a pap smear. As every single nurse and phlebotomist who had swiped my HMO card since January had told me, I was overdue for a pap smear. My file at Beilinson could not go forward without it. I was supposed to have one at the hospital at the end of March, but we ran out of time that testing day.

(My cervix has nothing to do with my kidneys, for the curious. It was part of the “general health screenings.”)

I tried to nudge the file forward with promises of sending along results once I had them,  but things ground to a halt. I quickly made an appointment with Random Gynecologist Who Had A Free Appointment – mine was just coming back from maternity leave and would never had been available. Then had to wait on the results. Which could not be hurried, for hell or high water. Deep breaths.

April also contained another 24-hour urine collection, because now I was an expert and could easily execute this. Plus some other shorter ones, I think. Give me any sort of container; I’ll pee in it. (Beware.)

Coming up in part II:
My mental health screening, where 1977 loomed large
Part III

False start
Part IV 
Hospital days
Part V
Why I did this

 

“Bad” Bananas

I am not much for dispensing marriage advice, mostly because people are so individual that the pat broad strokes that you get used to hearing often don’t apply to your specific relationship.

So instead I give you my Wisdom from Experience:

A “successful” (judge at your own peril) marriage is optimizing two people’s most unusual features in the most productive way.

It’s being able to guess at your partner’s reaction to a situation, but then adapt in a nanosecond when you realize you were totally wrong. This may happen a lot, because people are fucking whimsical. Stay alert.

Here’s one story from my marriage, circa yesterday/today.

Yesterday, I noticed we had four bananas going bad on the counter. “I am going to make muffins,” I said to myself. (NB: To myself.)  I make muffins a lot, about once a week, because the kids each take one to school every day. Not always banana (sad reason for that is coming up).

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Grab three friends and we’ve got a batch of muffins

I also went grocery shopping yesterday. We are coming into the time of year in Israel when bananas are breaking hearts all over the place. They are either hard and green or completely missing from store shelves. It is a tense few months.

So I bought green bananas. (It’s ok; we’re all healthy.)

Taxman often takes a banana for breakfast. He’s a good egg, so he eats them from almost anywhere on the banana chart, unlike me and the kids.

banana chart

Did you think I was joking about the chart? Also, this chart needs at least two more on the green end of the spectrum, if I am being honest. (Nobody eats those, though.)

Thus: I had the right number of squishy bananas on the counter to make a batch of muffins.

However, if it had been just one overripe banana on the counter, I would have wanted him to eat it ASAP. (Three – or two, in a pinch – can be a batch of pancakes, but one is utterly useless.) We have tried to freeze smashed overripe banana before, and it just never ends well; we don’t speak of it any more.

When I got down to unearthing my kitchen this morning, I discovered…all four bad bananas. Muffins are made. Kids have vittles.

monkey bananas

Sure, it’s messy, but what if it keeps them quiet for like four minutes? Then it’s totally worth it.

I don’t know if he:

a) left me the four bad bananas because he knew, telepathically
b) only saw the green bananas
c) skipped breakfast entirely
d) was concentrating on taking out the garbage

Naturally, our only communication today after 8:00 am has been about the kids’ math enrichment classes.

Nevertheless, I managed to snag some green-yellow bananas on the way home from Pilates, and I might even draw some hearts on them because the above non-incident incident is some prime family synergy optimization, you know?

Take care of your love in whatever way you do.

PS: We have been know to sing the chorus to both “Yes, We Have No Bananas” and “I Like Bananas (Because They Have No Bones)” because we excel at bemusing-slash-exasperating our children, and if that isn’t a strong foundation for the next 45 years I don’t know what is.

 

 

 

 

17 things I did right in 2017

If you’ve been here for a while, you probably know that I am not, shall we say, an optimist. I am not really a pessimist, either. I am just…pragmatic? By the age I am (42), life experience has primed me to expect certain things or patterns. So that’s what I do.

Which isn’t to say that I just allow myself to be swept along by fate or any such thing. I am trying to be an active participant in my own life. So here are 17 small decisions I made in 2017.

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  • I had weird physical symptoms and went to the doctor for testing and reassuring right away. This shouldn’t make news, right? But how many adults ignore symptoms for themselves that in their children would have them running for the phone? Lots.
    TL; dr – it seems that it was extremely typical lactose intolerance, not IBS or something dire.
  • On my gp’s advice, I cut out dairy. It was rough, because I have a thing for cheese. When I finally saw a GI specialist, a couple of months later, he said I could experiment with lactase, which mostly works. Dairy and I have come to a détente, one might say, although I am definitely not the cheeseaholic I was 12 months ago.
  • I have tried to be really strict with myself about exercising five times a week, some combo of Pilates, lap swimming, and fast dog walking, with an occasional tennis outing versus my son thrown in to keep me humble. Some days I only have time to bang out 500m in the pool (which I can now do in 18 minutes), but it feels like an investment in my future.
  • I learned a ton about how the American government works. It’s embarrassing that it took the worst president and most cruel Congress of my lifetime for me to get on that, but there you go. I probably knew some of these things in high school – that was a long time ago – but absolutely not all the ins and outs of how U.S. laws get built and passed. Lots of gratitude to Pod Save America for that.
  • I heard a lot of stories about compassion, and I hope to plug that into my own life. Yay, podcasts! (Death, Sex & Money – fantastic)
  • We started to use the library again after a long absence.
  • We stopped to pet street cats and friendly dogs. I show the Dog Rates twitter feed to my children because it makes us all happy.
  • I didn’t lie in job interviews. I can’t imagine who on Earth would want to get caught in those sorts of lies, but presumably lots of people have no issue with it. I believe it cost me a job for which I was overqualified, and it cost me a job in the final stretches of a ridiculously long hiring process for something that was not even middle management. I am going to stick with the “honesty is the best policy” program in 2018 and hope I don’t continue to get screwed over or ghosted (yes, this happened to me – twice in the same month) in the process.
  • I removed myself from uncomfortable situations when I could not make it better.
  • I tried not to feed trolls.
  • I actively sought out fiction written by non-white authors and found some amazing things. I am going to go further with this in 2018.
  • We found a way for our kids to talk to us on a regular basis. Sometimes it’s just silly family stories, but we’ve covered some serious subjects too. Before everyone goes Deep Teen and hates us for four to five years.
  • I tried to listen more and give advice less.
  • (Oh, god, not to my children. I am talking about full grown people, not huddled masses of hormones and questionable decision-making skills.)
  • I knit a couple of scarves as gifts. As a beginning knitter this was scary, but they were well-received as the extensions of love that they are.
  • I used a knitting + podcast combo to quell airplane traveling anxiety. Who knew this would work? Amazing.
  • Trying to plan for what I can control and relax on what I can’t. It is a work in progress, though. Adulting is a work in progress.

Hope things come up roses for you all in 2018.

Let’s not forget to get a new president.

 

Grit

I’ve been spending a lot of time lately thinking about what we can “give” to our kids versus what they develop on their own.

In some cases you lay out all the tools you possess right in front of them and wait for them to pick them up. (Manners, I am looking at you.)

[It’s kind of fascinating, if you have the distance to look at it like a documentary filmmaker. My internal narrator is nothing like David Attenborough, though – rather someone who is light on research and heavy on sarcasm.]

Anyway, this is a post about AM. He’s 11 now, more than halfway to 12, and has more than his share of self-possession. He’s passionate about math, games, and…tennis.

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AM has been playing tennis for 2 1/2 years. His universe begins and ends with Roger Federer. He was kind of alarmed a few weeks ago when Taxman and I listed all the tennis stars we could think of, stretching back to the early ’80s. You mean, there was professional tennis before Roger Federer? (Not sure he believed us when we told him that racquets were made out of wood not that long ago.)

I used to play extremely casually from maybe age 10-14, meaning I would accompany my mom and stepdad to the tennis court as they played (also casually), or play on brick walls. I played at summer camp. I had an average forehand, a terrible backhand, and could volley decently. Somewhere along the line I learned how to serve, but could never put a lot of power behind it.

This casual approach to tennis is not something my son can understand. He’s in a group class twice a week with several friends. But class is only 45 minutes, so he shows up 45 minutes early and plays on an empty court with a buddy. Most Sunday afternoons, when he has nothing happening after school, he calls a friend and goes to play for an hour or more. After he burns through his screen time on his phone (which is restricted, BADLY), he plants himself in front of the computer to watch videos of…Roger Federer. Oh, and also Hawk-Eye shots. (The first time he mentioned these, I made a joke about M*A*S*H, but like I said, this kid is suspicious of anything that happened before 2005, so he refused to engage.)

A month ago he fell on his left hand as he was chasing a loose ball and sprained two fingers. He called me, crying, as his fourth and fifth fingers turned indigo, and we bundled him off to urgent care. Two weeks in splints. But no matter, he was back on the court the next week.

This weekend, he won his division (of 23 kids) in his tennis school’s fall tournament. He passed through the first round with no trouble, then had closer matches in the semi-final and finals. (Not real games, but scoring individual points on a narrow half-court – which actually requires a lot of control to stop from going wide.)

But here’s the thing: He’s not a natural athlete. He’s in good shape because he bikes everywhere and runs around like a lunatic at recess, but he is not gifted in this way. He’s not tall, nor exceptionally strong. Yet he’s managed to claw his way to the top tier of some athletic things. He captured the last spot on his school’s tiny track team – six 5th and 6th grade boys – and competed in our city’s road race in November.

Same for tennis: He’s put in hours and hours and drawn himself by sheer will to the next level of play. He’s not a graceful player – just fierce. He has a great forehand, but his backhand fails him sometimes.  He’s had to learn to contain himself in order to put the ball between those restrictive lines. He sometimes gets furious with himself or his opponent (though this is improving). He’s less Federer and more McEnroe, sometimes. (Ema, Ema, he would sigh, McEnroe is left-handed. I am not left-handed. My literal heart.)

He has grit. This isn’t something we taught him; he just has it. (It’s not going to turn him into a professional tennis player, though, so eventually I hope he will direct it elsewhere.)

It makes me a little jealous, as I don’t think I recall ever being on fire for something as much as he is for tennis. Does reading novels on the couch count? Does that take grit? I once plowed through Anna Karenina in four days.

So I just sit and marvel. And overlook the trail of racquets and balls and shoes that line my living room. It seems like the least I can do.

Under construction

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My city, building, as always

I have been inhabiting a difficult space, between my past and my future. The questions of “What do you want to be?” and “What do you want to do?” have never been in such high relief.

Being unsure that my skills, relied upon in various iterations of employment for 20 years, match any answers to the above questions.

I wish I could skip ahead, through the hard part, to a place where I feel confident and worthy of whatever comes my way. I don’t even know what that experience would entail, honestly.

In the meantime, I might be writing here more. I should make a “to be determined” category, because “uncategorized” doesn’t seem aspirational enough.

Being amorphous is pretty terrifying.

Pray like nobody’s watching

Two days ago, in Machne Yehuda (one of Jerusalem’s markets), I stumbled upon a simple scene that really brought home what I’m doing here.

An Orthodox minyan, a prayer quorum, was meeting for the afternoon prayer in the back of a shop selling nuts, dried fruit, spices, and candy. Despite a synagogue deeper inside the market, a whole 90-second walk away, this ad hoc group just took a quick break from work or shopping and got it done.

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It still sometimes startles – and thrills me – to realize that Israel is full of religious people doing their thing. A lot of them are Jews. (Not exclusively; I’ve seen Moslem prayer rugs in use on roadsides and sidewalks as well. Jerusalem is also home to monks and nuns in their religious dress, who regularly take public transport and shop in the markets.) This isn’t to say that the atmosphere is suffused with it; in Tel Aviv, a much more secular-seeming place, afternoon prayers are usually decently tucked away in office meeting rooms, and non-kosher food options outnumber the kosher ones.

Anyway, after spending so many years in America trying to make my outward religious expression muted in order to shield myself from confrontation or awkwardness or, god, all the explaining, it is odd that I generally don’t have to anymore. (This is partially luck, as I haven’t had to be the only religious co-worker in a firm, which has definitely happened to people I know.) At work in America, I prayed in stairwells; said the grace after meals swiftly at my desk with my head nearly tucked under my desk. I pretended to like hats as a fashion statement.

The other day I was in a doctor’s waiting room with my son, and sunset was imminent. “Did you say mincha at school?” I asked.
“Not today,” he said.
“So do it right now; you’re about to run out of time.”
“Which way do I face [towards Jerusalem]?”
I pointed him the right way, approximately, and he just did it, in a room full of a dozen people.

It is a small thing, hard to describe, without seeming like a fanatic. But I was one of five Jews in my high school graduating class of a couple of hundred.

Watching my children blending in, seamlessly, puts air in my lungs.